The number of patients waiting more the four hours to be seen at Norfolk’s A&E departments has hit the highest levels since 2014.

Just 60pc of patients at the Norfolk and Norwich University Hospital (NNUH) were admitted, transferred, or discharged with four hours in January - the national target is 95pc.

While at the Queen Elizabeth Hospital (QEH) in King’s Lynn 74.9pc were seen within that time, and the number was 83.4pc at the James Paget University Hospital (JPUH) in Gorleston.

At the same time, the number of people turning up A&E had risen, as had the number of people who needed an emergency admission to hospital.

However, growing numbers of these people were waiting more than four hours to be treated - the target was last hit in 2014.

Alex Stewart, chief executive of patient watchdog Healthwatch Norfolk, said there needed to be a radical step change in how patients going to A&E with minor conditions were dealt with.

He said: “Nationally there are estimates that between 1.5m and 3.5m people who come to A&E could be dealt with elsewhere. There would be a substantial reduction in demand if people actually thought about where they go, and not just turning up at A&E for minor ailments.

“There are a whole host of other issues in that people know they will be seen, to some extent our hospitals are a victim of their own success.”

He pointed to the urgent care centre at the NNUH which aimed to better triage people away from A&E, and similar initiatives are in place at the other trusts.

But Mr Stewart said it could be take a step further and staff should turn away those better suited to other services, even offering to make them appointments with their GP or other clinicians.

“We need to get patient understanding of what’s available out there more but we should be able to turn people away,” he said.

Associate chief operating officer at JPUH Joanne Segasby said “extensive planning” and working with partners had softened the blow but it had been an “extremely challenging time”.

She said: “But once again, our staff have gone above and beyond to care for patients while displaying exceptional teamwork.”

And added: “We have faced a sustained period of high demand for much of January and into early February, which put intense pressure on our bed capacity.

“Extensive planning before winter, working closely with our partners, has helped – as have developments such as the expansion of our ambulatory care unit, which has helped us see a greater number of patients who previously would have attended our A&E department.

Caroline Shaw, chief executive at the QEH, said teams had “worked tirelessly” and applauded their commitment. She said: “I would like to take this opportunity to applaud our frontline teams in the emergency department for their tireless work and dedication. They try incredibly hard to assess and treat all patients who arrive at the front door as quickly as possible and I would like to thank them for the care they give.

“While our performance has not always been what we would aim for, all of our staff have continued to rally around and do their utmost for our patients in the face of growing pressure.

“Like many hospitals across the country, the QEH has seen an increase in the number of people attending the emergency department needing our help, including many seriously unwell and frail patients.

“Over the winter, we have implemented a number of a plans to help support the hospital’s performance, which have included the assessment zone and the surgical extended recovery unit. These have played their part to support the hospital during its busiest periods.”

While Mark Davies, NNUH chief executive, said despite “extensive plans for the anticipated increase in demand” the hospital had been under “extreme pressure”.

He said: “The response of our staff has been tremendous and I’d like to thank them for rising to the challenge and their continued dedication.

“Our emergency department teams have seen a 14pc increase in ambulance arrivals so far this year, compared with last January, and on occasion we have had to open appropriate escalation areas across the hospital.”

NHS was better prepared but patients still affected

Nationally, A&E waits have reached their worst level since the four-hour target was introduced in 2004.

In January 84.4pc of patients were treated or admitted within four hours, meaning nearly 330,000 patients waited longer that they should.

A further 80,000 patients waited for more than four hours to be transferred to a ward from A&e due to a lack of beds.

More patients are going to A&E and delays in discharging patients, which are often due to social care packages not being in place, have fallen. And there was also the sense the NHS was better prepared for the winter. Even though demand continued to increase, operations were not cancelled and there were not as many ambulances queuing outside A&E departments.

However Dr Taj Hassan, president of the Royal College of Emergency Medicine, said: “The suffering affecting our patients in emergency departments in England has not gone away at all.”